PLEASE READ THE TERMS IN THIS AGREEMENT AND RELEASE OF LIABILITY CAREFULLY.
PARTICIPANTS ARE REQUIRED TO SIGN THIS FORM AND HAND IT OVER TO CLASS INSTRUCTOR.
ALL MINORS ARE REQUIRED TO HAVE PARENTS/GUARDIAN SIGNATURE OF CONSENT.
For and in consideration of participant's registration with Eastern Dance Studio (referred to as"Studio) and being allowed to participate in classes, workshops, performances and activities, the undersigned participant or the parent(s) or legal guardian(s) of participants, relinquish any and all liability for and cause of action for personal injury, property damage or wrongful death occurring to I, the (participant), arising out of participation in the Studio classes, workshops, performances and activities incidental thereto, whenever or however they occur and for such period said activities may continue, and by this agreement any such claims, rights, and causes of action that participant may have are hereby relinquished and the participant (or parent(s)/guardian(s)) does(do) so on behalf of my/our and participant's heirs, executors, administrators and assigns.
Participant and/or participant's parent(s)/guardian(s) acknowledge, understand and assume all risks in inherent participation in said activities, and understand that said activities may involve risks to participant's person including bodily injury, partial or total disability, paralysis, and death, and damages which may arise there from and that I/we have full knowledge of said risks. These risks and dangers may be caused by the negligence of the participant or the negligence of others, including the "releasees" identified below. It is further acknowledged that there may be risks and dangers not known to us or are not reasonably foreseeable at this time. I/We agree to abide by and be bound under the rules of Eastern Dance Studio, including those instructions by the instructors Eastern Dance Studio.
Participant and/or participant's parent(s)/guardian(s) acknowledge, understand and assume the risks, if any, arising from the conditions and use of related premises used by the Studio and acknowledges and understands that included within the scope of this waiver and release is any cause of action, arising from the performance, or failure to perform maintenance, inspection, supervision or control of said areas and for the failure to warn of dangerous conditions existing at said premises, for negligent selection of certain releasees, or negligent supervision or instruction by releasees.
Participant or participant's parent(s)/guardian(s) agree if any claim for participant's personal injury or wrongful death is commenced against releasees, he/she shall defend, indemnify and save harmless releasees from any and all claims or causes of action by whomever of wherever made or presented for participant's personal injuries, property damage or wrongful death.
Participant and/or participant's parent(s)/guardian(s) acknowledge that they have been provided and have read the above paragraphs and have not relied upon any representations of releasees, that they are fully advised of the potential dangers of dance instruction and understand these waivers and releases are necessary to allow said dance instruction to exist in its present form.
I certify that my physician has examined me and that I am in good physical condition and have no disease or injury that would impair my performance or physical condition in participating in the aforementioned activities of the Studio including training for and competing. (Note: For recent injury or injuries, a physician's report must be attached to this form. My promise to indemnify: I agree to pay all costs and expenses, including attorneys' fees and court costs, that the Studio may incur as a consequence of any legal action arising out of (1) injury, death, or damage to me; or (2) injury, death or damage to someone else as a result of my conduct.
I, the participant and/or participant's parent(s)/guardian(s) also acknowledge, and understand that all dance routines, classes, workshops and seminars materials used by Eastern Dance Studio are protected by copyrights laws and may not be used without prior written consent from founder of Eastern Dance Studio.
I fully accept all risks and responsibility for all losses and injuries I incur as a result of my participation.
I am in good health and physically fit to engage in this activity and state that he has no medical condition which could jeopardize my safety, health and well being during such participation or be aggravated by my participation in this event.
I am aware that DANCING involves jumping, bending, spinning, rapid arm movement, sliding back and forth and, skipping and those other participants around me and as such could be dangerous; I don't expect to be struck by others during the dance routine scenario or myself strike others by accident but, should that happen and I be seriously injured, or even die as a result of such contact or over exhaustion, I freely engage in this activity and assume any and all risks and hazards to my person and my property that may occur during such activity, even as the result of negligence or carelessness by any person or by any cause known or unknown.
In consideration of the above and previous declarations, I, the participant, do release from liability, hold harmless forever and agree not to seek suit or any claims against Eastern Dance Studio its employees, its sponsors, its partners, the landowners or their family or any person, company or party with an interest in the aforementioned property; or any other participant including those in charge of the management and production of the event, that I will not cause any claim, action, demand or cause of action resulting from negligence of personnel, event organizers and/or the landowner arising from my participation in this event.
I also grant full permission for Eastern Dance Studio to use photographs and/or video footage of me in legitimate accounts and promotions of the classes and events of the Studio.
DATE (YYYY/MM/DD): ________ /_____ /_____
PARTICIPANT'S FULL NAME: __________________________________
PARTICIPANT'S SIGNATURE: _________________________________
PARENT/GUARDIAN FULL NAME: ___________________________________
PARENT/GUARDIAN SIGNATURE: __________________________________